Alternatives to cow's milk

Milk is a good source of many nutrients including protein, iodine, vitamin A, vitamin D, riboflavin (vitamin B2), vitamin B12, zinc and, importantly, calcium. Australian dietary guidelines recommend we include two or three serves of milk, its products or alternatives each day.

But what are your options if you have an allergy or intolerance to dairy and can’t drink it, or for ethical and environmental reasons you’d rather avoid it? Or you just plain don’t like it? An increasing range of beverages made from soy, cereals and nuts can be found in supermarkets and health food shops. But are they nutritionally adequate substitutes for cow’s milk, and should you choose one over another?

According to Tania Ferraretto, spokesperson for the Dietitian's Association of Australia (DAA), a major consideration is your overall diet. “If you’re avoiding milk because you just don’t like it – but you’re still eating other dairy products such as cheese – then you can probably base your choice purely on taste and cost,” she says.

Watching your weight or worried about your cholesterol? Then add low kilojoule and low fat to your buying criteria. But if you follow a vegan diet, for example, then “choosing a substitute that’s high in protein and calcium should be a priority,” says Ferraretto. And, generally speaking, alternatives with 2.5% or less fat aren’t suitable as a substitute for cow’s milk for children under the age of two.

CHOICE verdict

The alternative most suitable for you depends on your overall diet or reasons for avoiding cow’s milk. One option might be to keep more than one type for different uses – soy milk on your cereal for a little extra protein and calcium, rice milk for baking and a glass of chilled almond milk for a low-kilojoule snack, for example.

However, in terms of nutrients, calcium-fortified soy is the best substitute for cow’s milk. If you’re removing cow’s milk and its products from your diet completely, consult a dietitian to make sure you choose the most suitable alternative for your needs. Visit the DAA to find one near you.

Cow's milk allergy & intolerance

A cow’s milk allergy occurs when your body produces antibodies against the protein (casein and/or whey) in milk. In this case all cow’s milk and its products – and usually goats and sheep milk – must be avoided. Intolerance, on the other hand, is likely to result from an accumulative reaction to lactose, the dominant sugar in milk.

For people with lactose intolerance, lactose-free cow’s milks are an option. Pauls Zymil Lactose Free and Liddells Lactose Free are common brands. People with lactose intolerance may also find that they can tolerate cheese and yoghurt made from cow’s milk, as they’re lower in lactose.

If you suspect you have a cow’s milk allergy or intolerance seek the advice of your GP and get a referral to an immunologist, allergy specialist or an accredited practising dietitian for help and advice. A correct diagnosis and dietary advice is vital as a lifetime of avoiding foods unnecessarily can be a hassle and more importantly can mean you miss out on essential nutrients.

03.Milking your options

Almond milk

$2.79-6.95 per litre*

Almond milk contains the same heart-healthy fats as olive oil, and is naturally low in kilojoules and saturated fat. It contains a moderate amount of protein but only one of the five brands we found is fortified with calcium. Most products we reviewed have added sweeteners – look for sugar or agave, cane or rice syrup on the ingredients list.

Coconut milk

$5.95 per litre*

Coconut milk is low in carbs and kilojoules, but is significantly higher in saturated fat than other non-dairy alternatives and is lacking in protein and calcium.

Oat milk

$2.49-5.95 per litre*

Oat milk is relatively low in fat and saturated fat, and offers a moderate amount of protein. It also contains cholesterol-lowering beta glucan. However, two of the four products we looked at aren’t calcium-fortified. And oat milk may not be suitable for people with gluten intolerance.

Rice milk

$1.99-3.70 per litre*

Rice milk is the most hypoallergenic of all the milk substitutes, and 12 of the 15 products we reviewed are calcium fortified to levels similar to cow’s milk. It’s low in fat and saturated fat, but it’s also low in protein. None of the products we reviewed were sweetened, but rice milk is naturally high in sugars – it’s twice as sugary as soy milk on average.

Soy milk

$1.49-4.60 per litre*

Soy milk has more protein on average than other alternatives, so it’s good for vegans and those who don’t get protein from meat sources. Most products we reviewed are calcium-fortified to a level similar to cow’s milk, and are also frequently sweetened. Regular soy milk has a higher fat content on average than the alternatives, so it’s a good cow’s milk substitute for kids under two who can tolerate it (soy is a common allergen). Soy milk contains isoflavones, a class of phytoestrogens thought to have a protective effect against some cancers, although it’s recommended that women with oestrogen-dependent breast cancers limit soy foods. Soy milk is available in a range of varieties including organic, high fibre, barista quality and milky-tasting.

*Prices are based on those paid in Sydney supermarkets and health food stores in February 2012.